In brief: CMS releases nat’l health expenditures, OIG says two brands dominate mail-order market for diabetes supplies

 - 
Friday, December 9, 2016

WASHINGTON – Per-capita healthcare spending grew by 5% and overall healthcare spending grew by 5.8% in 2015, according to a recent study by the Office of the Actuary at CMS.

Those rates continue to be below the rates of most years prior to the passage of the Affordable Care Act.

“Even as millions of people gained coverage, per-enrollee spending growth in private health insurance and Medicare continue to be well below the average in the decade before passage of the Affordable Care Act,” CMS stated.

The report concludes that expenditure growth in 2015 was primarily the result of increased use and intensity of services as millions gained health coverage, as well as continued significant growth in spending for retail prescription drugs.

On a per-enrollee basis, overall spending increased by 4.5% for private health insurance, 1.7% for Medicare and 3.8% for Medicaid.

Healthcare spending grew 2.1% faster than the overall economy in 2015, resulting in a 0.4% increase in the health spending share of gross domestic product, from 17.4% in 2014 to 17.8% in 2015. In the decade prior to the passage of the ACA (2000-09), healthcare spending increased 2.8% faster than GDP on an annual average basis.

Per-enrollee Medicare spending increased by 1.7%, about the same rate as in 2014 and below the average annual growth in per-enrollee spending during 2000-09 of 7%. Medicare spending, which represented 20% of national total healthcare spending in 2015, grew 4.5% to $646.2 billion.

Overall Medicaid spending and enrollment grew at a slower rate in 2015 than in 2014 with per-enrollee spending increasing 3.8%. Medicaid spending, which totaled $545.1 billion, accounted for 17% of total spending on health care. Similarly, growth in Medicaid enrollment slowed to 5.7% in 2015, significantly lower than the 2014 increase of 11.1%.

Out-of-pocket spending, which includes direct consumer payments such as copayments, deductibles and spending not covered by insurance, but excludes premiums, grew 2.6% in 2015, compared to the average annual growth during 2000-09 of 4.6%.

OIG: Two brands dominate mail-order market for diabetes supplies

WASHINGTON – Two brands of test strips account for half of the Medicare mail-order market for diabetes supplies, according to a new report from the Office of Inspector General.

The OIG, which looked at claims submitted from April to June 2016, also found that the top 10 brands of test strips accounted for 93% of the mail-order market. Altogether, suppliers submitted claims for 30 different brands of test strips.

The OIG conducted the study to help CMS understand which brands of test strips were provided to beneficiaries prior to the start of the Round 2 re-compete of the national mail-order program. The Round 2 re-compete began July 1, 2016, with pricing of $8.32 per box of test strips vs. $10.41 per box in the previous round of the program.

The Medicare Improvements for Patients and Providers Act requires CMS to award contracts to providers whose bids cover at least 50%, by volume, of all brands of strips on the market.

The top three brands by market share, according to the OIG, are Prodigy (28.2%), OneTouch Ultra (22.8%) and Embrace (11.5%).

In November, Sens. Dan Coats, R-Ind., and Mark Warner, D-Va., introduced the Diabetes Supplies Act to ensure that all Medicare beneficiaries have access to their preferred brand of test strips.

NSM extends reach in Southeast

NASHVILLE – National Seating & Mobility has acquired the rehab division of Georgia-based Integrity Medical. The acquisition include four branches in Augusta, Macon and Savannah, Ga., and Columbia, S.C. “We’re happy to be adding to our footprint in the Southeast with the team and quality operation acquired from Integrity Medical,” stated Bill Mixon, CEO of NSM, in a press release. “As we grow, the addition of highly qualified people continues to make us a better company.” Brian Byler, ATP, and Marc Smith, ATP, principals at Integrity Medical will continue with NSM. Chris Mayo, ATP, will continue in the Macon branch, and Steven Still, ATP, will provide products and services from Columbia. “Being part of the NSM team gives us the freedom and greater resources to provide mobility to our clients,” stated Byler in the release. Integrity Medical will continue to operate its DME division.

Inogen transitions management, expands board

GOLETA, Calif. – Inogen will have a new CEO on March 1. The company announced Dec. 6 that Scott Wilkinson, currently president and COO, will succeed Ray Huggenberger, who is retiring. Wilkinson will also join Inogen’s board of directors effective Jan. 1, 2017. Huggenberger will remain on the board following his retirement. Additionally, Byron Myers, founder and vice president of Inogen, will be promoted to executive vice president of sales and marketing effective Jan. 1, and Scott Beardsley, a senior partner at Novo Ventures, will join the board also on Jan. 1. Wilkinson has spent 11 years at Inogen, in a wide variety of leadership roles in everything from customer service; to sales and marketing; to global commercial, manufacturing and support operations. From 2000 to 2005, he worked at Invacare as a group product manager, helping to launch a $100 million in revenue oxygen product line.

Harmar names new CEO

SARASOTA, Fla. – Steven Dawson is the new CEO of Harmar Mobility, the company announced Dec. 9. He has also been appointed to Harmar’s board of directors. Dawson’s career includes leadership roles managing and executing transformation, growth and development of organizations across a variety of industries. “We are excited we were able to recruit Steve to lead Harmar,” said Jeffrey Lipsitz, managing partner at Cortec Group, Harmar’s controlling shareholder. “We had worked with Steve on another investment that was very successful and were impressed with his focus, high energy and ability to lead and develop teams.” Cortec acquired Harmar in 2012.

Abbott wants to ditch Alere

WALTHAM, Mass. – Abbott Laboratories has sued Alere in an effort to terminate its buyout of the company, according to news reports. Chicago-based Abbott has filed a complaint in the Delaware Court of Chancery, asking a judge to terminate the deal on the grounds that Alere is no longer the company Abbott agreed to buy 10 months ago. Alere’s problems include CMS revoking the billing privileges of its DME supply business, Arriva Medical, amid allegations that it submitted claims for 211 dead patients over the past five years. Previously, Alere sued Abbott in the same court, asking a judge to enforce the deal. That lawsuit is ongoing.

Diplomat Pharmacy unites infusion companies

FLINT, Mich. – Diplomat Pharmacy has launched Diplomat Specialty Infusion Group, a new brand to unite five subsidiaries: American Homecare Federation, At-Home IV Infusion Professional, BioRx, MedPro Rx and XAS Infusion Suites. “As we continue to build on the work we have done, we are excited to move forward with the launch of our new brand,” said Phil Hagerman, CEO and chairman. “Together, our combined resources allow us to continue to build upon our expertise and services for patients with specialized needs.” Diplomat Specialty Infusion Group will continue its focused services on hemophilia and other bleeding disorders, hereditary angioedema, Alpha-1 antitrypsin deficiency and immune globulin.

ResMed recognized for responsible corporate behavior

SAN DIEGO – ResMed has been named to JUST Capital and Forbes magazine’s inaugural “JUST 100 List” for responsible corporate behavior. It is one of only three healthcare devices and services companies to join the list, which was generated based on criteria established from one of the largest surveys ever conducted on attitudes toward corporate behavior, involving 50,000 Americans over the last 18 months. The list ranks U.S. companies against their peers within 32 major industries. The ranking rates companies based on fair pay, equal opportunity employment, job creation, safety, compliance and respect for employees. The list will be featured in Forbes magazine’s “Impact and Philosophy” issue on Dec. 20.

Quantum hits milestone on Facebook

EXETER, Pa. – Quantum Rehab’s Facebook page has surpassed 15,000 “likes” and followers. Quantum created the page in 2012, seeking to connect with consumers and to participate in all areas of disability culture. “We use our Facebook page to keep all informed on product advancements, but we also post a lot of human-interest content,” said Megan Kutch, director of marketing, in a press release. “This mixture, along with direct consumer interaction, has made the Quantum Facebook page a true place for online disability culture.” The page is updated daily with feature-rich stories on everything from new products to inspiring news stories to community events.

SMRC cuts providers some slack

WASHINGTON – SMRC contractors will give providers more time to respond to results letters, AAHomecare reported this week. The association had notified CMS that providers were being inundated with letters, and reviewing them and gathering supporting documents has been an overwhelming process. If providers need more time, they can send a written request to the SMRC for a discussion and education session within 30 days of the date of the final results letter, AAHomecare says. In their requests, providers should request a 14-day extension to submit supporting documents.

EZ Access Bathing & Mobility donates scooter

ABERDEEN, N.C. – EZ Access Bathing & Mobility partnered with Stars N Stripes Scooters to donate a scooter to the Welcome Home Veterans Living Military Museum at Richard’s Coffee Shop in Mooresville, N.C. That organization will give the scooter to a mobility-impaired veteran. Chuck Barnes, owner of EZ Access, is himself a disabled Vietnam veteran. "EZ Access Bathing & Mobility is proud to be associated with Stars N Stripes Scooters,” said Barnes. “The quality of their products and their customer service are exceptional. Their desire to step up and give back exhibits their excellent values.”

FODAC gets greener

STONE MOUNTAIN, Ga. – The Friends of Disabled Adults and Children (FODAC) is the recipient of the Community Foundation of Greater Atlanta’s latest “Grants to Green” giving cycle. The $175,000 matching grant will support green updates to FODAC’s corporate offices and warehouse in Stone Mountain/Tucker, Ga., making it operate more efficiently and freeing up additional funds to support services. “FODAC has always promoted a ‘green’ initiative,” said Chris Brand, president and CEO of FODAC. “Repurposing and recycling used equipment provides much of our inventory to supply the needs of our clients and keeps almost 350 tons of equipment and related parts, like batteries, out of landfills.” FODAC provides equipment like wheelchairs and patients lifts to the disabled community at little to no cost.

AOPA seeks abstracts

WASHINGTON – The American Orthotic & Prosthetic Association has issued a call for papers for the AOPA World Congress slated for Sept. 6-9 at the Mandalay Bay Resort in Las Vegas. The committee is accepting abstracts for Clinical Free Papers, the Technician Program, Business Education Program and the Symposia, in addition to a special Student/Resident Poster Submission category. AOPA has a list of topics of special interest, including osseointegration, public health topics, CAD/CAM, alternative payment methods, and more. The submission deadline for clinical, technical, and symposia topics is March 1, 2017. The deadline for business topics is Feb. 1, 2017. For more information: www.aopanet.org.

SCA helps grant senior wish

PHILADELPHIA – SCA is continuing its partnership with Wish of a Lifetime, a nonprofit organization that seeks to fulfill the dreams of seniors to shift how society views aging, and Brookdale Senior Living, the nation’s largest operator of senior living communities. On Saturday, Dec. 10, Wish of a Lifetime will send 88-year-old James Salvatore to a naval base in Norfolk, Va., to tour an active military submarine. Salvatore, of Williamsburg, Va., is a Navy veteran. SCA is a leading global manufacturer of personal hygiene and forest products.

People news: VGM, HOMES, MedBridge

The VGM Group has tapped Jim Greatorex as vice president of its Accessible Home Improvement of America division. He will be responsible for overseeing AHIA’s nationwide network of certified providers and contractors, and helping them develop business strategies to educate consumers on the many products and services available to them to live independently. Greatorex joined VGM in 2015 as director of business development for its Retail Services division. Jerry Keiderling, formerly president of AHIA, is still with VGM but working in in a different division…Jason Canzano, managing director of Acelleron Medical Products, has accepted a board position with the Home Medical Equipment Services Association of New England. Canzano joined Acelleron Medical Products in 2013, when Preferred Home Health Care & Nursing Services, acquired the company. As managing director, Canzana finds new business opportunities inside and outside of the HME industry, manages daily operations and oversees Maternal Health & Wellness, a company acquired by Acelleron in 2014…MedBridge Healthcare, a provider of sleep disorder diagnostic services and treatment, has named Ghentry Pace as CEO. Pace brings more than 20 years of healthcare experience in clinical, operational and financial arenas. He has held executive leaderships roles in integrated healthcare systems, such as Intermountain Healthcare, and a number of Fortune 500 healthcare providers, including Apria Healthcare and Conifer Health Solutions. Most recently, he served as the senior revenue cycle leader for Fresenius Medical Care, a dialysis provider. As CEO of MedBridge, Pace will lead a staff of 545 direct services, sleep and respiratory professionals.

Product news: ApniCure, DeVilbiss

Redwood City, Calif.-based ApniCure has made its Winx Sleep Therapy System for obstructive sleep apnea available for direct purchase by consumers. Winx provides relief from OSA without a mask, making it ideal for patients who can’t or won’t use a CPAP machine, the company says. The system, which is cleared by the U.S. Food and Drug Administration, was previously only available in select sleep labs. Winx is currently available to consumers only in California, but ApniCure plans for broader distribution in 2017…Port Washington, N.Y.-based DeVilbiss Healthcare has been awarded a patent for its suction container replaceable filter cartridge. “This invention’s unique design helps to isolate the user and the suction device from the contents of the container by combining a traditional ball float shutoff mechanism with a replaceable hygroscopic filter cartridge,” said Allan Jones, director of engineering for DeVilbiss Healthcare. The container is meant to be used with medical suction and aspiration devices.